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Severe learning disability contraception ethics — DFSRH MCQ

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HardSpecial circumstancesSevere learning disability contraception ethicsDFSRH

A 19-year-old with severe learning disability is brought by her mother requesting DMPA to stop periods. The patient appears distressed during the consultation and cannot explain her wishes today. There is no urgent medical indication. What is the most appropriate management?

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Correct answer: B — Assess capacity and best interests with safeguarding consideration

Contraceptive decisions for someone who may lack capacity require decision-specific capacity assessment, supported communication and best-interests decision-making, with safeguarding considered. Parental request alone is insufficient in an adult. Sterilisation would be a major irreversible intervention requiring stringent legal and ethical safeguards.

Reference: FSRH Contraception for Individuals with Disability; Mental Capacity Act